Where Do Kids Learn About Sex?

June 11, 2001 -- Which factors matter most to teens deciding whether to become sexually active? Peer pressure? Media images? Education? Religious background? All play a role, but new research suggests parents may have the most influence of all.

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You may think they're tuning you out when the talk turns to birds and bees, but they're not, according to two studies released in April by the National Campaign to Prevent Teen Pregnancy (NCPTP) that reinforce the role of parental advice and role-modeling in determining the sexual behavior of teens. In those studies, more teens, 38%, pointed to their parents as the biggest influence on their sexual behavior -- more than friends, the media, educators, siblings, or religious organizations.

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In recognition of this, the organization urges parents to engage their children "early and often in discussions of sex, love, relationships, and values."

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"A lot of parents wonder when to have 'the talk' with their kids," says Ingrid Sanden of NCPTP. "The answer is never. You have to create an environment where your kids feel comfortable coming to you when they need answers, and that means keeping things open from the time your kids are old enough to understand."

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Both mom and dad need to start the dialogue early and keep the lines of communication open, she says. Many parents who are otherwise fearless when it comes to keeping their children safe become cringing, tongue-tied cowards at the thought of talking to them about sex. But it may be one of the most important steps they can take to protect them.

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Parents should also establish rules and standards of expected behavior, Sanden says. They should discourage frequent and steady dating among younger teens, take a strong stand against a daughter dating a significantly older boy or a son dating a much younger girl, and emphasize the value of education.

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"Parents are really important in forming their kids' values," Sanden says. "It is strange to even have to say that, but so many parents feel that they are powerless, especially with teens."

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One Million Teen Pregnancies Each Year

Although teen pregnancy and birth rates in the U.S. declined significantly during the 1990s, approximately 1 million American teenage girls still get pregnant each year. That is by far the highest rate of teen pregnancies of any industrialized nation -- and eight out of 10 are unplanned, according to NCPTP figures.

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After rising 23% between 1972 and 1990, pregnancies among girls between the ages of 15 and 19 declined 17% between 1990 and 1996. The teen birth rate dropped by 20% between 1991 and 1999, to approximately 50 births per 1,000 young women.

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So is the drop in teen pregnancies due to fewer adolescents having sex or to better contraception use among those who are sexually active?

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The answer depends on whom you ask. Groups promoting abstinence until marriage say their message is finally getting through, and statistics do suggest fewer teens are having sex than a decade ago. High-profile celebrities who have gone public with their virginity, such as pop singer Jessica Simpson and NBA star A.C. Green, have helped to give the abstinence movement a certain cachet among the young.

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"I go to a private school, and the majority of my peers are abstinent," 18-year-old high school junior Nick Reid tells WebMD. "I don't know if you can say that at most public schools, but that may be a gross generalization." Reid, who lives in Nashville, serves on the NCPTP's youth leadership team.

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A report from the Alan Guttmacher Institute, the nation's largest nonprofit organization studying reproductive health, suggests three-fourths of the recent decline in pregnancies among teens is due to better contraceptive use and only one-fourth is due to abstinence.

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"If people are suggesting that abstinence is the primary reason for the decline in pregnancy rates, that is just not accurate," says Cynthia Dailard, senior policy analyst with the institute. "We see politicians, including the president, pushing abstinence-only education and calling for teens to abstain from sex. But research shows that comprehensive methods of sexual education that discuss methods of contraception, while encouraging teenagers to delay sexual activity, are most effective."

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Abstinence vs. Contraception

As a presidential candidate, George W. Bush repeatedly expressed his support for abstinence-only school-based programs, saying a top administration priority would be to "elevate abstinence education from an afterthought to an urgent goal." In a speech delivered in July 1999, candidate Bush said, "It seems like to me the contraceptive message sends a contradictory message. It tends to undermine the message of abstinence."

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The comments appear to contradict the findings of the nation's top public and private health organizations. A National Institutes of Health report, published in 1997, called sexual abstinence a desirable objective, but added that, "programs must include instruction in safer sex behavior, including condom use." The American Academy of Pediatrics weighed in on the issue in a report published early in 2001, noting that "all adolescents should be counseled about the correct and consistent use of latex condoms to reduce the risk of infection."

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And a newly released NCPTP study evaluating sex education programs found that education efforts that discuss contraception use do not hasten the onset of sex, increase the frequency of sex, nor increase the number of sexual partners among teens. Likewise, making condoms and other contraceptives available in schools does not hasten or increase sexual activity, the report concluded.

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A survey of parents, conducted last year by the Henry J. Kaiser Family Foundation, found that four out of five agreed that information about contraceptives should be included in school-based sex education programs. The National Campaign to Prevent Teen Pregnancy survey found that more than 90% of adults and teens said a strong abstinence message is important, but 69% of adults and 67% of teens said it was also important to teach contraception.

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"Only a handful of conservative politicians are pushing the more stringent abstinence education, but they are very powerful," Dailard says. "And parents and teachers aren't willing to be real vocal about this issue."

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Sanden calls the debate over abstinence vs. contraceptive use counterproductive and irrelevant, and high school junior Reid agrees.

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"The fact is, teens need to choose either abstinence or contraception, and many aren't motivated to make that choice." Sanden says. "Kids who don't think about this ahead of time are the ones who have a huge risk of getting pregnant."

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"I think you can get into a war of words with the abstinence vs. contraception debate, and you probably won't go anywhere with that," Reid adds. "Abstinence is the best and most desired method of preventing pregnancy, but it is also not very realistic for many teens."

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Opening the Dialogue

So how do parents approach discussions of sex with their children? First, don't hesitate to express your own opinions about what is appropriate behavior, according to recommendations from the NCPTP. Make sure the discussions are age-appropriate, but be prepared to get specific with older children and teens.

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Monitoring the magazines they read and the television they watch may be a good way of easing into discussions of sex, Sanders says. She admits that it takes some courage to watch teen-oriented nighttime soap operas like "Dawson's Creek" and "7th Heaven" with your kids. A story line on "Dawson's Creek" this season, for example, had main characters Joey and Pacey having sex, and Joey fearing that she might be pregnant.

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"You may be cringing the whole time you are sitting there watching, but later on it is going to pay off," she says. "Instead of throwing up your hands and ranting about how the media is such a terrible influence, you could use the situation to talk about the consequences of sex."

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Teens, Reid says, need to feel they can talk to their parents about sex.

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"I think parents are pretty uncomfortable talking about sex, but it is important and they need to address it," he says. "Kids do respect their parents' opinions, but the parents don't really know that. They don't think they have an influence, but they actually do."